Combined procedure with radial probe and convex probe endobronchial ultrasound

Abstract

Background: Concurrent bronchoscopy using radial probe and convex endobronchial ultrasound (RP- and CP-EBUS) is used to simultaneously evaluate both peripheral lung lesions for the histological diagnosis of the primary tumor and mediastinal lymph nodes for mediastinal staging. So far, little is known about the combined procedure with RP- and CP-EBUS. Methods: Between January 2020 and March 2021, the bronchoscopy database was reviewed to identify the clinical outcomes of the combined procedure with RP- and CP-EBUS. Patients who underwent transbronchial biopsy using RP-EBUS alone were classified as the RP-EBUS group, while those who underwent a combined procedure with RP- and CP-EBUS were classified as the combination group. Results: The overall diagnostic yield of the bronchoscopic procedure in the combination group was significantly higher than the RP-EBUS group (90.7% vs. 70.0%, p < 0.001). CP-EBUS increased the diagnostic yield of the bronchoscopic procedure in the combination group by 9.3%. Although the mean procedure time was significantly longer, and the mean doses of midazolam and fentanyl were significantly higher in the combination group (p < 0.001), there were no differences in the overall complication rates between the two study groups (1.4% and 1.0% for the RP-EBUS and combination groups, respectively, p = 0.766). Conclusions: Combined bronchoscopy using RP- and CP-EBUS is feasible and safe. In addition to mediastinal staging, CP-EBUS increased the overall diagnostic yield of the bronchoscopic procedure by 9.3%.